Botanicals for COPD/Asthma Flashcards
Which botanical is commonly used for its stimulating expectorant properties in the treatment of COPD?
A) Lobelia inflata (Indian Tobacco)
B) Aspidosperma quebracho-blanco (Quebracho)
C) Ephedra sinica (Ma-Huang)
D) Hyssopus officinalis (Hyssop)
Correct Answer: B) Aspidosperma quebracho-blanco (Quebracho)
Rationale:
B) Aspidosperma quebracho-blanco is known for its stimulating expectorant action, particularly beneficial for conditions like asthma, cough, and URTI with phlegm.
A) Lobelia inflata is an expectorant but also has emetic and sialogogue effects.
C) Ephedra sinica is a broncho-relaxant and used in conditions like asthma and bronchitis, but its primary action is not as an expectorant.
D) Hyssopus officinalis is a mild expectorant but not as stimulating as Aspidosperma quebracho-blanco.
Which botanical should be avoided in pregnancy due to its emmenagogue properties?
A) Crocus sativa (Saffron)
B) Glycyrrhiza glabra (Licorice)
C) Ephedra sinica (Ma-Huang)
D) Hyssopus officinalis (Hyssop)
D) Hyssopus officinalis (Hyssop) has well-established emmenagogue properties, which can stimulate menstrual flow and is contraindicated in pregnancy.
A) Crocus sativa (Saffron) can have mild emmenagogue effects, but it is generally safe in small culinary amounts. However, larger doses should be avoided.
B) Glycyrrhiza glabra (Licorice) is not specifically contraindicated in pregnancy but should be avoided in large amounts due to its potential effects on blood pressure and fetal development.
C) Ephedra sinica (Ma-Huang) is contraindicated in pregnancy due to its stimulating effects on the heart and blood pressure, rather than emmenagogue properties.
Which botanical contains ephedrine and pseudoephedrine, making it useful for bronchodilation in COPD patients?
A) Crocus sativa (Saffron)
B) Polygala tenuifolia (Milkwort)
C) Ephedra sinica (Ma-Huang)
D) Inula helenium (Elecampane)
Correct Answer: C) Ephedra sinica (Ma-Huang)
Rationale:
C) Ephedra sinica is a sympathomimetic herb that contains alkaloids like ephedrine and pseudoephedrine, which are useful for bronchodilation in COPD patients.
A) Crocus sativa (Saffron) has antioxidant and anti-inflammatory properties but does not contain bronchodilating alkaloids.
B) Polygala tenuifolia is used for neuro-psycho conditions and inflammation but not for bronchodilation.
D) Inula helenium (Elecampane) is used primarily as an expectorant, not for bronchodilation.
Which botanical has an action of potentiating corticosteroids by inhibiting 11-beta-hydroxysteroid dehydrogenase type 2 enzyme?
A) Polygala tenuifolia (Milkwort)
B) Glycyrrhiza glabra (Licorice)
C) Marrubium vulgare (Horehound)
D) Coleus forskohlii (Coleus)
Correct Answer: B) Glycyrrhiza glabra (Licorice)
Rationale:
B) Glycyrrhiza glabra (Licorice) contains glycyrrhetinic acid, which inhibits the enzyme 11-beta-hydroxysteroid dehydrogenase type 2, potentiating corticosteroids.
A) Polygala tenuifolia has anti-inflammatory actions but does not potentiate corticosteroids.
C) Marrubium vulgare does not potentiate corticosteroids but is known for its anti-inflammatory and expectorant actions.
D) Coleus forskohlii acts on heart conditions and weight loss, not corticosteroid potentiation.
Which botanical is contraindicated in individuals with a known ragweed allergy due to its family classification?
A) Marrubium vulgare (Horehound)
B) Inula helenium (Elecampane)
C) Polygala tenuifolia (Milkwort)
D) Glycyrrhiza glabra (Licorice)
Correct Answer: B) Inula helenium (Elecampane)
Rationale:
B) Inula helenium belongs to the Asteraceae family, which includes ragweed, making it contraindicated for individuals with a ragweed allergy.
A) Marrubium vulgare is from the Lamiaceae family and does not cause allergic reactions related to ragweed.
C) Polygala tenuifolia is from the Polygonaceae family, so it does not have cross-reactivity with ragweed.
D) Glycyrrhiza glabra is from the Fabaceae family and not related to ragweed allergies.
This herb is known as an expectorant, and breaking up mucous. Think muculyptic think of the eu-cah-lyptus
Eucalyptus
* Part— leaf, bark;
* Constituents— acids– gallic acid, ellagic acid, caffeic acid; flavonoids– quercetin, rutin, catechin; volatile oils— 1,8 cineol (eucalyptol > 70%), beta-pinene, alpha-pinene, limonene; resin; waxes; beta-sitosterols;
* Actions— anti-inflammatory; antimicrobial; antiviral; expectorant; mucolytic; spasmolytic;
* Other— analgesic; antioxidant; antiproliferative; antiseptic;
* URTI— mucopurulent, yellow; post-nasal discharge; bronchopulmonary catarrh;
- Viral infections— smoke from leaves; diffused essential oil; peak plasma at 18 minutes, half-life 104.6 minutes;
- COPD trial— N=272, dose 200 mg TID eucalyptol vs placebo; 6 months; Sig– Asthma Quality of Life Questionnaire, FEV1; SE– nausea, diarrhea, heartburn;
- Posology– ⌀ 20-60 gtt TID, < 5 mL TID; essential oil 2-10 gtt in carrier oil; infusion/decoction 20 – 60 gtt TID; diffuse 2-
10 gtt essential oil PRN; - Combinations— Thymus vulgaris Essential Oil;
- Toxicity— 1 tsp may be fatal; vertigo; contact dermatitis;
Eucalyptol = 1,8-cineol
This herb relaxes the bronchioles and the bronchi
Aspidosperma quebracho-blanco;
Apocynaceae
- Part— bark. Constituents— proanthocyanidins; quebrachitol; indole alkaloids– quebrachine; rhazinilam; tannins; sterols;
- Actions— asthma; cough; URTI with cough and phlegm; lung congestion; stimulating expectorant;
- Other— hypertension; spasms; edema; fever; pain; low libido;
- Posology— ⌀ 10-30 gtt TID, 0.5-1.5 mL TID;
- Cautions— bitter irritation may cause nausea that could lead to vomiting;
- Pregnancy and Lactation— no data
Quebrachine (Yohimbine)
Rhazinilam
This herb is also used in SUD, is an expectorant. Low dose stimulate and high doses suppress
Lobelia inflata; Campanulaceae
* See Substance Use and Abuse
* Part— leaf, flower, seed
* Constituents— piperidine alkaloids– lobeline, isolobeline, chelidonine, piperidine,…); bitter glycosides– lobelacrin; chelidonic acid; inflatin;
* Actions— expectorant; emetic; sialogogue;
* Indications— labored breathing with a sense of suffocation, precordial pain, oppression, heaviness; angina or neuralgia extending from the chest;
- Posology— ⌀ 5-40 gtt QD; 1-10 gtt TID/QID;
- Toxicity— low doses stimulate, high doses suppress; esophageal burning, nausea, vomit; Tx– IV diazepam if seizure; GI lavage; keep warm;
- Pregnancy and Lactation— no data;
Lobeline - is the image of its structure
This is one of the oldest studied herbs but caution its use with thyroid disease (as this is a stimulating herb), CV disease, Diabetes, cardiac glycosides & MAOIs.
Ephedra sinica; Ephedraceae
* Part— branches, aerial portions;
* Constituents— sympathomimetic/phenethylamine alkaloids– ephedrine, pseudoephedrine, norpseudoephedrine, isoephedrine; tannins; quinoline; kynurenic acid; anthocyanidins; saponins; flavonoids; volatile oils;
* Actions— broncho relaxant; beta-2 adrenergic receptor activity;
* Indications— URTI; asthma; hay fever; bronchitis; edema; hypotension; antimicrobial– Pseudomonas aeruginosa, Staphylococcus aureus, Aspergillus niger;
- Posology— ⌀ 10-30 gtt TID, 1-4 mL TID; decoction 2 tsp/cup TID; 15-50 mg total alkaloids QD;
- Cautions— thyroid Dz (due to stimulating); CV Dz; diabetes; with cardiac glycosides; MAOIs;
- Toxicity— stimulation of the autonomic nervous system and HPA axis à tachycardia, hypertension, arrhythmia;
- Pregnancy and Lactation— no data;
Ephedrine & Pseudoephedrine
This herb has been known to lower eosinophils in guinea pigs
Coleus forskohlii; Lamiaceae
Name- Plectranthus barbatus, Coleus barbatus;
* Part— Root, stem
* Constituents— terpenoids– forskolin; tannins; saponins; flavonoids; cardiac glycosides; phlobatannins;
* Actions— anti-hypertensive; hypothyroid; used for CV dz; chest pain; obesity;
* Trials— may mitigate wt gain in mildly overweight females who recently lost weight; no measured parameters changed (Not Sig)– body mass, fat mass, metabolic markers, lipids, enzymes, CBC, thyroid, insulin, BP, HT rate;
- Asthma— lowered eosinophils in guinea pigs; Sig decreased IL-4, IL-5, IL-17, BALF, interferon-gamma; Sig increased IL-10; J Cell Biochem.2019.120(6):9648-9655.doi.10.1002.jcb.28243.
- Posology— 50-100 mg standardized to 18% forskolin BID/TID; in CV Dz 100-300 mg QD;
- Pregnancy and Lactation— no data; some historical use;
Forskolin
This herb is also a sedative, but it also decreased IL-6/TNF-alpha. High doses can causes emmenagogue.
Crocus sativa; Iridaceae
* Part— stigma, styles; leaf; root; the stigma and styles used to be collected first morning right after the dew but recent research shows the leaf and root are just as effective where the formal is labor intensive
* Constituents— volatile oils, bitter glycosides– picrocrocin, crocetin, safranal, crocin;
terpenes; carotenoids; B1, B2;
* Actions— carminative; stomachic; sedative; anxiolytic; emmenagogue; antidepressant;
* Other— antioxidant; anti-inflammatory; decrease IL-6, TNF-alpha; dysmenorrhea;
* Posology— ⌀ 5-20 gtt TID, 0.3 – 1.25 mL TID; powder 20-40 grains TID; 20-100 mg QD; food- use stigma for flavor/color;
* Pregnancy and Lactation— no data; historically
Crocin
This herb is part of the mint family therefore it is apart of the Lamiaceae family, & is a carminative. CI in pregancy as It maybe an emmenagogue in high doses.
Hyssopus officinalis;
Lamiaceae
* Part— aerial parts; perennial;
* Constituents— essential oils– pino-camphone, iso-pino-camphone, limonene, beta-pinene; flavone glycosides– diosmin; flavonoid glycosides– rutin, quercetin; phenolics; tannins;
* Actions— anti-inflammatory; antimicrobial; carminative; expectorant;
* Other— antifungal; antioxidant; bitter ()mild); cough reliever;
* Chronic respiratory conditions— weak expectorant; mild biter;
- Topical— bruises; ulcers; (Grindelia robusta
more effective); eczema; psoriasis; - Antimicrobial— anti- Gram+ & Gram -: Staphylococcus pyrogens, S. aureus; Candida albicans; Escherichia coli; anti-HIV and Kapsoi sarcoma;
- Mice— asthma models– against IL-4, IL-6, IL- 17, IFN-gamma; restore Th1/Th2 balance; 200 g in 6000 mL water/d; similar to dexamethasone in mice;
- Posology— ⌀ 10-20 gtt TID; to 2.5 mL TID; infusion 1-3 tsp, steep covered; 20 g in 100
- Pregnancy and Lactation— CI pregnancy as may be emmenagogue; no data for either;
- Caution— nausea, upset stomach, CNS upset;
- Toxicity— hyssop oil > 0.13 g/kg may induce convulsions, fatal at 1.25 g/kg;
has this chemical structure in it - beta-Pinene
This herb can potentiates corticosteroids, however the removal of dlycyrrhetinic acid make this now called DGL and does not potentiate corticoid steroids. DGL does potentiate triple therapy for H pylori. Is antiviral & antimicrobial
** Glycyrrhiza glabra/uralensis; Fabaceae**
- Part— root
- Constituents— triterpene glycosides– glycyrrhizin, glycyrrhetinic acid; phytosterols; flavonoids; volatile oils; polysaccharides;
- Actions— anti-inflammatory; demulcent; expectorant; antimicrobial; estrogenic; respiratory demulcent; GI demulcent;
- Other— tonifies SP chi; augments Qi; moistens LU; clears heat; harmonizes and leads other botanicals into the 12 channels; flavor to hide other botanicals;
- Potentiates corticosteroids— glycyrrhetinic acid inhibits 11-betahydroxysteroid dehydrogenase type
2 enzyme (HSD2); may elevated cortisol; - deglycyrrhizinated (DGL)— protects GI; potentiates triple therapy for H. pylori;
- Antimicrobial— antiviral– HSV-1, Epstein- Barr, H1N1; SARS-CoV-2; prevents viral entry;
- Posology— decoction ½ - 1 tsp TID; ⌀ 10-40 gtt TID, 1-3 mL TID; solid extract ¼ tsp TID; DGL 500 mg TID/QID;
- Caution— may elevate BP; hypokalemia; corticosteroid use;
- DGL— no side effects known
- Pregnancy and Lactation— no data but recommended against except for DGL;
Glycyrrhetinic Acid
This herb is also good for OCD as it and insomnia -if it is caused by depression. It is also useful for HSV & HIV
Hypericum perforatum (St. John’s Wort);
Hypericaceae
* Part— flower, aerial parts; perennial;
* Constituents— napthodianthrones– hypericin, pseudohypericin; bisanthroquinone glycosides; flavonoids– quercetin, rutin, hyperoside, catechin, kaempferol; phloroglucinol derivatives– hyperforin; volatile oils; coumarins;
* Actions— antidepressant; anti-inflammatory; antimicrobial; nervine relaxant; vulnerary;
* Depression— mild to moderate;
* Anxiety— with OCD;
* Insomnia— arising from depression;
- Neuralgia— spinal injury; shock; concussion; trigeminal neuralgia;
- Viral infections— oral and topical; HSV; HIV;
- Posology— ⌀ 30 gtt TID, to 1.5 mL TID; solid extract standardized to hypericin (0.3%) 125-
250 mg QD; capsules standardized to hypericin (0.3%) 320 – 1800 mg QD; infusion 1-2 tsp per cup BID; oil in olive oil TID; - Caution— photosensitivity if large doses;
- Pregnancy and Lactation— no data; adverse effects in Wistar rats;
- Medications— utilizes CYP450-3A4;
- Combinations— Allium sativum + Verbascum Thapsus + Olea europaea; Passiflora incarnata; Valeriana officinalis; Actea racemosa;
Hypericin and Hyperforin
This herb is good for ,bronchitis, LRTI & URTI as it is a great expectorant. It is also apart of the Asteraceae family (sunflower)
Inula helenium; Asteraceae
* Part— root; leaf and flower antioxidant, antimicrobial; perennial;
* Constituents— caffeic acid; carbohydrates; chlorogenic acid; flavonoid– epicatechin, catechin gallate; phenolics; sterols– beta- sitosterols, gamma-sitosterols, stigmasterol; sesquiterpene lactones; terpenoids; volatile oils;
* Actions— anti-inflammatory; antispasmodic; anti-tussive; expectorant; diaphoretic;
* Other— antimicrobial; cytotoxic; digestive tonic; neuroprotective;
- Respiratory— asthma, cough, bronchitis, URTI and LRTI; may aid with viscous phlegm;
- GI— dyspepsia; cholagogue; peptic ulcers; alantolactone soothes and heals stomach;
- Posology— decoction 10 g in 200 mL water, simmer, let soak 2 h; ⌀ 20-60 gtt TID, to 6 mL QD;
- Caution— Asteraceae (ragweed is part of that family)pollen allergy;
- Pregnancy and Lactation— no data;
- Toxicity— LD50 > 5g/kg in mice, rats;
Alantolactone
This herb is an antimicrobial but very effective for gram +, is indicated for asthma as well.
Marrubium vulgare; Lamiaceae
* Part— aerial
* Constituents— alkaloid– stachydrine; diterpene– marrubiin; essential oils– citronellyl, geranyl, beta-carophyllene; flavonoids– rutin, quercetin, kaempferol; phenolic acids; phenylpropanoid esters; phytosterols; vit C; resin;
* Actions— anti-inflammatory; anti-asthmatic; antispasmodic; diaphoretic; expectorant;
* Other— antibacterial; antifungal; tonic; vasorelaxant; acetyl-cholinesterase inhibitor; ferric ion chelator; hepatoprotective;
- Antimicrobial— esp. Gram+; Staphylococcus epidermidis, S. aureus; Enterobacter cloacae; Bacillus subtilis; Micrococcus luteus; Botrytis cinera (fungi);
- Posology— ⌀ 20-60 mL TID, 1.5 – 4 mL TID; infusion 1-3 tsp per 120 mL TID/QID, steep covered; syrup PRN for cough;
- Caution— Europe Medical Association limits to 7-14 d;
- Pregnancy and Lactation— no data;
- Combinations— Glycyrrhiza glabra; G. uralensis; Althea officinalis;
has Citronellyl - (good for repelling mosquitoes and is very relaxing)
Kaempferol
This stops the breakdown of Dopamine, acetylcholine, serotonin, norepinephrine and increases BDNF (Think poly because it does a lot). Also known as Dwarf milkwort
Polygala tenuifolia; Polygonaceae
- Part— root
- Constituents— saponins; tenuifolisides– tenuifolin; xanthones; oligosaccharides; alkaloids; coumarins; lignans; flavonoids;
- Actions— psycho-neuro conditions; insomnia; depression; amnesia;
- Other-– anti-inflammatory– NOx , iNOS, COX-2, PGE2, TNF-alpha, IL-1 beta, IL-6, LPS; delays COPD in smoke-induce mice;
- Saponins— prevent decrease of NMDA in aged animals; inhibit beta-amyloid synthesis (which prevents alzheimers);
- Mechanisms— inhibit breakdown of acetylcholine, dopamine, serotonin, norepinephrine; increases BDNF;
- COPD— cigarette mouse study 2024
- Posology— decoction 9-12 g/d; 100-300 mg TID; mice ~ 2g/kg/d toxic;
- Pregnancy and Lactation— no data;
Tenufolin
